In the grippe: H1N1, then and again

January 12, 2014

The North Dakota Department of Health alerted residents Thursday to the onset of the flu season, with at least 843 cases being confirmed across the state. The department noted that the actual prevalence is likely higher, as people with mild cases tend not to visit the doctor and not all illnesses are sampled and tested when they do.

This year's season is unusual in that the prevalent strain of influenza is the H1N1, which was globally pandemic in 2009. The health department's report advises people to seek vaccination, and warns the H1N1 strain peculiarly affects more children and young- to middle-age adults than other strains might.

Though now almost a century ago, in 1918, state health officials expressed similar concerns about the same strain of flu, which at the time was being called Spanish grippe, Spanish flu, or simply "the grip."

Article Photos

This wartime reminder in an October 1918 edition of The Minot Daily News admonshes readers to cover their faces when sneezing in public. Many advertisements and notices of the time were thematically linked to the nation’s war effort.MDN File Photo

Though the virus was considered "epidemic" by Sept. 13 of that year, flu went unremarked in The Minot Daily News until Oct. 1. Even then, the notice was small and at the bottom of the back (then the eighth) page. The front pages of the time were splashed instead with stories of World War I then raging in Western Europe, of homefront food rationing and collection drives for the $6 billion Fourth Liberty Loan.

Minot health officers warned that the city was beset by the grippe, but would not confirm whether it was Spanish influenza.

"The thing for Minot people to do is to keep themselves in the best possible conditions," they advised. "This is one time when every precaution for good health should be observed. As for closing the schools, I don't know how much of the disease there is, but I wouldn't advise anything of that sort unless there is a serious need of it."

Recommended precautions then were similar to those given today: "Cover your nose with your hankerchief when you sneeze, your mouth when you cough. Change handkerchiefs frequently." In addition, people were advised to avoid visiting the sick or "expectorating in public places," while also eating "plain food," avoiding alcohol and keeping one's feet warm.

In the next day's paper, Gertrude Esther Olson was reported dead from the flu at the age of 26, leaving behind a husband and children. The day after, a Rev. Father Mittereder of Foxholm was said to be "gravely ill" with pneumonia. "Little hope was extended this afternoon for his recovery." He died the next day.

The daily editorial in that day's issue of The Minot Daily advised readers "to beat the grippe, forget it," sarcastically attributing "this new and malign variety of grippe to the foe of all humanity - Germany." At the time, the disease was thought to have started in Spain, though Spanish officials in turn blamed it on the Germans. To this day, the actual place of the illness' origin is debated, ranging from China to Kansas.

Wherever it started, the virus accompanied returning troops to America by late 1918, ravaging military encampments and training facilities worse than "the Hun's" machine-gun emplacements ever could, before spreading across the country like wildfire. Whether it came to Minot on the cough of a returning doughboy or the sneeze of an itinerant fieldhand recently arrived for threshing work, the disease had well established itself within that first week.

By Oct. 5, the newspaper's Society column began to fill with notices of ill health, of recovery, of death and canceled or postponed events. A variety of home remedies were suggested or otherwise made fun of, and advertisements for miracle cures such as Pape's Cold Compound and Scott's Emulsion appeared. One remedy still recognizable today, called "Vick's Vapo Rub," had cleverly disguised its advertisement as a health notice.

Two days later, 32-year-old Harlan Shiek, "one of Minot's prominent young business men," had died. Even so, it was reported that "the epidemic of influenza in Minot is being handled satisfactorily by the authorities, and it is not thought that it will be necessary to close the public schools. ... Most of the cases in Minot are of a mild nature."

On Oct. 9, Surgeon General Rupert Blue recommended to all state health officials the closure of schools and public amusements. The dead to-date around the country was reported at 4,910. The next day Minot's public schools were ordered closed by its health officer, Dr. H.G. Knapp, "in conformity with a federal order and the recommendation of the state health authorities." Despite occasional bouts of optimism, they would remain closed for over a month.

Two of the nurses attending to Shiek were taken ill with the flu soon afterward, as was Dr. Knapp himself. More people died, ranging in age from their mid-20s to late-30s. Red Cross volunteers begin making surgical face masks, urging the public to wear them. Strangely, the organization posted a notice the next day, expressing concern that it needed more knitting volunteers to meet its quota of sweaters to send to the troops.

Whole families were taken ill. On one day, James Eagan and his 15-year-old daughter, Gladys, reportedly died of the flu. A pair of brothers lost their wives the same day, and one man from Wisconsin was taken deathly ill after coming to Minot for his sister's funeral. By mid-month, 500 cases were reported in Minot, 2,000 in Fargo, with more in Grand Forks. Despite repeated assurances from a recovered Knapp and other health officials that the epidemic was on the wane or under control, by the month's end record numbers of new cases were being reported, 47 one day, 53 the next.

Though outbreaks would linger on into the next spring, the epidemic broke by the end of November. In all, the total number of flu dead for North Dakota was at around 2,700; nationally, 675,000 had died, with anywhere from 20 million to 40 million dying worldwide.

Today's state health officials remind us that it is not too late to be vaccinated for H1N1. And while their health releases a century ago might have more of a jingle to them than now, the common-sense prevention remains unchanged: "Cover up each cough and sneeze; if you don't you'll spread disease."